India Extends Price Cap to 137 Cancer Drugs Following Supreme Court Ruling

The Indian government announced on Thursday that 137 cancer medicines will see price reductions starting in November. This move follows a Supreme Court ruling that described the previous pricing structure for these drugs as extortion. The policy extends a 30% cap on trade margins to a wider list of pharmaceuticals, a limit that had previously applied to only 42 drugs.

The legal action originated from a petition filed by Sarojam Radhakrishnan, a former bank clerk from Kerala. Diagnosed with breast cancer in 2021, she faced monthly treatment costs exceeding 63,000 rupees, a sum her family could not afford. She approached the Kerala high court in 2022 to compel the government to lower these expenses.

When the case reached the nation’s highest court, judges examined the supply chain. Justices Vikram Nath and Sandeep Mehta noted during a hearing on September 29 that a specific drug supplied to hospitals for 2,700 rupees was sold for 27,000 rupees. The court characterized the practices of hospitals, distributors, and retailers as causing carnage and extortion through excessive margins.

Data from the National Pharmaceutical Pricing Authority indicated that trade mark-ups on certain cancer drugs averaged 170%, with some instances exceeding 700%. The Department of Pharmaceuticals stated that the new cap is expected to reduce medicine prices by up to 70%. The ministry projected that this change would help cancer patients save 2,500 crore rupees annually.

The financial strain on patients remains a central issue in Indian healthcare. Krishan Kalra, a former council member of the Rajiv Gandhi Cancer Institute and Research Centre, noted that many people avoid free diagnosis camps because they fear the cost of treatment if cancer is detected. Cancer drugs currently range from 38,000 to 380,000 rupees, often forcing families to leave consultations without a treatment plan.

Existing insurance mechanisms provide limited protection. The government's Ayushman Bharat scheme offers 500,000 rupees in annual coverage per family. This amount equals the cost of a single dose of Kadcyla, a breast cancer medication that may require up to 14 doses. Dr. Ravi Kannan, a surgical oncologist in Assam, described the new pricing cap as a welcome step for patient access.

India records approximately 1.56 million new cancer cases annually, a rise from 1.39 million in 2020. Jyotsna Singh, co-convener of the Working Group on Access to Medicines and Treatments, warned that hospitals might offset lower drug prices by increasing other charges. The Supreme Court has asked the government to justify why the cap does not apply to all non-patented medicines, with a response due by October 27.

Radhakrishnan died in September 2022 while her case was still pending in the Kerala courts. Her petition ultimately triggered the judicial review that led to the current pricing reforms.